South Carolina Statutes
§ 38-71-1840 — Exemptions.
The provisions of this article do not apply to an audit, review, or investigation:
(1)that involves alleged insurance fraud or abuse, Medicare fraud or abuse, or other fraud or misrepresentation;
(2)conducted by or on the behalf of the Department of Health and Human Services in the performance of its duties in administering Medicaid under Titles XIX and XXI of the Social Security Act; or (3) notwithstanding the exemptions under subsections (1) and (2) of this section, contracts between the South Carolina Department of Health and Human Services and Medicaid-managed care organizations must include provisions for biannual audits of Medicaid-managed care organizations' pharmacy pricing and include limitations on any pharmacy benefits manager contract arrangements that bill the Medicaid progr
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Legislative History
HISTORY: 2012 Act No. 250, SECTION 1, eff January 1, 2013; 2023 Act No. 30 (S.520), SECTION 1, eff January 1, 2024. Editor's Note 2023 Act No. 30, SECTION 7, provides as follows: "SECTION 7. This act takes effect January 1, 2024, but the recurring examinations by the Department of Insurance provided for in Sections 38-71-2250(B)(1) and 38-71-2340(B)(1) must not begin before January 1, 2025." Effect of Amendment 2023 Act No. 30, SECTION 1, added (3) and made nonsubstantive changes. ARTICLE 19 Health Carrier External Review Act
Nearby Sections
15
§ 38-71-100
Policies exempt from chapter.§ 38-71-1010
"Blanket accident and health insurance" defined.§ 38-71-1020
Requirements as to policies.§ 38-71-1040
Payment of benefits.§ 38-71-105
Disability income insurance.§ 38-71-1050
Legal liability of policyholders not affected.§ 38-71-1310
Short title.§ 38-71-1320
Purpose and intent.§ 38-71-1330
Definitions.